Healthcare Provider Details

I. General information

NPI: 1174445597
Provider Name (Legal Business Name): PREMIER COMPREHENSIVE HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20008 S ELLSWORTH RD STE 105
QUEEN CREEK AZ
85142-0348
US

IV. Provider business mailing address

20008 S ELLSWORTH RD STE 105
QUEEN CREEK AZ
85142-0348
US

V. Phone/Fax

Practice location:
  • Phone: 480-660-9202
  • Fax:
Mailing address:
  • Phone: 480-660-9202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. IYENGAR MALINI
Title or Position: OWNER
Credential: MD
Phone: 480-660-9202